Personal/Family barriers

Acceptability

Services must be desirable and viewed as acceptable to the patient/client and family. Physical setting, demeanor, and scope of services all must be acceptable.

Language/Literacy

Patients/clients experience significant barriers when important information is complex and not in their native language. Complicated systems such as application for Medicaid present perceived and real barriers in literacy and native language. Further, workforce studies underscore the lack of providers who speak the language and are from the same culture as the populations they serve. Thus, barriers are influenced by provider and patient factors.

Culture

Health care providers and facilities that do not understand the cultural expectations and norms of the service populations present obstacles to accessing care. Lack of knowledge about the culture further creates difficulty in achieving compliance with necessary medical treatments.

Attitudes, Beliefs

The relationship between the provider of services and the patient/client involves mutual respect and understanding. Barriers occur when patients/clients perceive attitudes and beliefs about the nature of their health as negative and not consistent with their own beliefs about their health. This results in delays and lack of compliance that undermines successful treatment outcomes. Provider negative attitudes (fear, homophobia, discomfort of dying patients) in caring for HIV/AIDS patients is one example.

Human Behaviors

Individual characteristics may serve as barriers to treatment. Patients with physical or emotional disabilities may find it difficult to find services to meet their needs. Health care providers, on the other hand, behaving in a courteous and respectful manner are likely to facilitate the engagement of at-risk patients/clients.

Education/Income

Multiple studies have documented that lower income and less educated populations do not access the health care system to the same extent that more educated affluent populations do. Utilization and quality are notably less for some groups and higher utilization (such as emergency rooms) occurs in other populations. With increasing health care costs, more of the population is experiencing “out-of-pocket expenses” as a barrier to obtaining services.